Public Entity Application Port/Transportation/Airport ...
|[pic] |Euclid Public Sector |
| |234 Spring Lake Drive |
| |Itasca, Illinois 60143 |
| |Phone (630) 238-1900 Website: |
| | Mailbox: |
| |mail@ |
Public Entity Application
Illinois / Indiana Township Supplemental Questionnaire
(Attaches to EPS-GEN-APP Applicant Information Section)
Legal Name of Public Entity: Effective Date:
A. BASIC FUNCTIONS
Which of the following basic function do you perform?
General assistance for the indigent
Assessment of real property for the basis of taxation
Maintenance of all roads and bridges outside the federal, state and other jurisdictions
(that have been accepted into the township road system)
Fire protection
B. AUXILIARY FUNCTIONS
Which of the following auxiliary function do you perform?
Senior Citizen programs
Youth Programs
Assistance to the disabled
Parks and Recreational facilities
Health Services
Cemetery maintenance
Land use
Other (please describe)
The undersigned declares that to the best of his/her knowledge, the information set forth in this application is true and complete.
Signature of Authorized Public Official Title Date
Refer to EPS-GEN-APP application form for the state fraud warnings.
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